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Antecedents The events happen in Northern South American countries with coasts on the Caribbean Sea and a wide border zone. The events happen in Northern South American countries with coasts on the Caribbean Sea and a wide border zone. In the border region of the neighboring country (A), the animal health services notified, during May an equids febrile disease event (equines, asnals and mules), with fast diffusion towards other localities. An indigenous group that inhabits that border zone, notified cases in its asses. In the border region of the neighboring country (A), the animal health services notified, during May an equids febrile disease event (equines, asnals and mules), with fast diffusion towards other localities. An indigenous group that inhabits that border zone, notified cases in its asses. By those time this ethnic group makes an annual trip to the neighboring country (B), to make marine salt harvesting activities By those time this ethnic group makes an annual trip to the neighboring country (B), to make marine salt harvesting activities

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Outbreak evolution Towards the end of July, on the other side of the border (country B), the animal health authorities, notified the presence of an outbreak of febrile disease with nervous signs in equids. During that month a transition between the rains season and the dry station happened, flood zones persisted and strong vectorial activity: Ochlerotatus (Aedes) taeniorhynchus; entomological research were carried out, to evaluate the population density of several species of mosquitoes, revealing a high density of Ochlerotatus taeniorhynchus, Psorophora confinnis; Culex quinquefasciatus, Anopheles spp, Culex spp and Deinocerites pseude1 adults and larvae. Towards the end of July, on the other side of the border (country B), the animal health authorities, notified the presence of an outbreak of febrile disease with nervous signs in equids. During that month a transition between the rains season and the dry station happened, flood zones persisted and strong vectorial activity: Ochlerotatus (Aedes) taeniorhynchus; entomological research were carried out, to evaluate the population density of several species of mosquitoes, revealing a high density of Ochlerotatus taeniorhynchus, Psorophora confinnis; Culex quinquefasciatus, Anopheles spp, Culex spp and Deinocerites pseude1 adults and larvae. Between the 8 and the 16 of September, the health services notified an increase in the number of clinical consultations for febrile disease compatible with classic dengue. An attack rate greater than 60 % was found (febrile picture). Between the 8 and the 16 of September, the health services notified an increase in the number of clinical consultations for febrile disease compatible with classic dengue. An attack rate greater than 60 % was found (febrile picture).

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¿Do you think there is any relation between the cases of humans and animals? According to your criteria what would be the basis to justify that relation. Consider the period of time, the subjects involved and the areas where the facts happened

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Outbreak investigation About what diseases would you think? Make a list of them and indicate the most probable ones.

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With this information, How would you make the diagnosis? What samples would you take? ¿ How would you send the samples? How would you interpret the results?

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Diagnosis While you are waiting the results, what actions World you take? In humans, the report of the sanitary authorities was: cases hospitalizations Dissemination rate 5 km/Day Increase in the number of abortions/Month 3000 neurologically affected cases 300 associated deaths Isolation of EEV virus subtype 1C Most affected ethnic group: Wayuú Source: Reyes, M., Villamil, L., De la Hoz, F., 2006 The report in animals was: 137 affected farms 38 with diagnose of Venezuelan equine encephalitis (by laboratory) 12 with diagnose of east equine encephalitis (by laboratory) 87 with clinical diagnose Given the rapidity with which the epidemics and epizootics of VEE are scattered in the different geographic areas, an intervention of effective emergency is required; once a center of EEV is characterized in the zone, the actions of center control are made, by means of pre- established plans of contingency.

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Which is your role as veterinarian in public health? What actions must be taken? Think on the intersectorial cooperation. Discuss it Give attention to the intersectorial cooperation, the comunicattion, the animal movement control, the vaccinations program, the epidemiologic surveillance systems, the vector control and the community participation..